Volatile substance abuse ( VSA) is the deliberate inhalation of products, of which there are many ( Table 1), to achieve intoxication. It is also known as 'solvent abuse', and in the United States and elsewhere as 'inhalant abuse'. Amyl (pentyl) and isobutyl nitrites ('poppers') have different patterns of misuse, and so are not discussed here; details can be found elsewhere. (1>

Table 1 Some products that can be abused by inhalation

VSA has dose-related effects similar to those of other hypnosedatives. Small doses rapidly lead to 'drunken' behaviour similar to the effects of alcohol, and may induce delusions and hallucinations. Some users inhale large quantities; a glue sniffer can consume 6 litres of adhesive weekly.

Long-term effects include listlessness, anorexia, and moodiness. The hair, breath, and clothing may smell of the substance(s) used, and empty product containers (e.g. glue cans, cigarette lighter refills, and aerosol spray cans), and bags used to inhale from, may be found.

Being readily available, volatile substances are, along with alcohol and tobacco, the first drugs tried by teenagers. They may therefore introduce youngsters to intoxication and be 'gateways' to illegal drug use. But VSA does not inevitably lead to the use of other psychoactive substances, and those that 'descend the slippery slope' to problematic misuse have other difficulties in their lives.(3)

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